A protective effect of insulin on reperfusing the ischaemic rat heart shown using 31P-NMR.

The effect on the recovery of mechanical function, ATP, phosphocreatine, Pi and pH of various lengths of total global ischaemia in the insulin-treated, perfused rat heart has been studied using 31P-NMR. Insulin-treated hearts recovered stable mechanical function after 18 min ischaemia when their intracellular pH was 6.0 and 70% of the pre-ischaemic ATP remained. Hearts perfused without insulin fail to recover after 18 min ischaemia, having an intracellular pH of 6.3 and 40% of ATP remaining (Bailey, I.A., Seymour, A.-M.L. and Radda, G.K. (1981) Biochim, Biophys. Acta 637, 1-7). Thus, ATP maintenance in ischaemia is more important to recovery on reperfusion than is maintaining intracellular pH. The importance of this observation in devising biochemical strategies for the clinical protection of the myocardium is discussed.